BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
Benefits of Cognitive Behavioral Therapy: How Individuals Cope with Behavioral Problems
Whittani Edwards
University of Cincinnati Blue Ash
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
Benefits of Cognitive Behavioral Therapy: How Individuals Cope with Behavioral Problems
Families experience problems and some of them handle it worse than others, and some
have larger issues than others. Individuals are left to suffer from the distress in the relationship
and the difficulties of trying to solve them. This why today there are counselors who are willing
to be the mediator in these situations. Although the belief and trust of counseling sessions vary in
benefit for families, research has shown that cognitive behavioral is effective in helping to cope
with the behavioral problems of individuals diagnosed with depression, anxiety, PTSD, and
marital distress. Therefore the question arises as to why cognitive behavioral counseling is used
and the efficacy for those diagnosed with depression, anxiety, PTSD, and marital distress. Not
only is this proven to be true in the United States but also in Germany as well. While studies
have proven that therapists are effective and CBT is useful there are other therapists who
disagree.
Counseling is professional guidance utilizing psychological methods especially in
collecting case history data, personal interviews, and testing interests and aptitudes (Webster’s,
2014). Counseling is a client-therapist session that allows the person or group to connect with the
therapist. In doing so clients go through cognitive behavioral therapy, or CBT, to help take the
necessary steps in understanding their problems and learning ways to fix them. Martin (2007)
says that CBT is a short-term, goal-oriented psychotherapy treatment that takes a hands-on,
practical approach to problem-solving. Moreover, Cognitive-Behavioral Therapy, or CBT, is the
approach to help solve a person’s issues by setting goals to help cope with behavioral and social
problems. In the efforts to help solve these issues the counselor must first work with the client
and listen to what he has to say and basically analyze his personality in order to begin a goal
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
setting. CBT is needed for most individuals, couples, and sometimes families who are
experiencing distress and need help with ways to go about them. Trusting and putting faith in the
therapist as a client helps with being able to open up and express the issues at hand.
History of Cognitive-Behavioral Therapy
According to Martin (2007), in the 1960’s a psychiatrist named Aaron T. Beck observed
that patients had an internal dialogue in their mind as if they were talking to themselves but
would only report a small portion of the problem. People aren’t always aware that the thoughts
that pop up in their head should be spoken. Yet, Beck realized that the link between thoughts and
feelings was very important (Martin, 2007, p.1). Thoughts and feelings are what help a person
make an important decision or to help him control his actions. Beck also found out that
identifying the negative thoughts that a person thinks when feeling upset was the key to the client
understanding and overcoming his or her difficulties (Martin, 2007, p.1). Noting that this is one
of the first steps in solving the root of the problem, goals then set will help to fix them. Beck’s
theory resulted in the findings of cognitive behavioral therapy which is and has been the most
successful and well known therapy in counseling.
Goals of Cognitive-Behavioral Therapy
The goal in CBT is to help the patients learn and recognize the negativity in their
behavior. Therapy is ultimately needed to have a mediator of the client’s problem almost like an
outside source to help them understand on their own what problems they are facing. Martin
(2007) says “cognitive-behavioral therapy differs from many other types of psychotherapies
because sessions have a structure, rather than the person talking freely about whatever comes to
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mind” (p.1). Without a structure, therapy will be disoriented and the client will just be allowed to
just say whatever comes to mind whereas starting with talking about one problem is less
confusing. The beginning of therapy aims to discuss the specific problems whether it be
troublesome symptoms, or life problems (Martin, 2007, p.2). For example troublesome
symptoms may be sleeping, interpersonal skills, or the transition of college. While life problems
include depression, anxiety, and distress these are the basis of the behavioral issues that this
research paper will include.
Looking at ways to begin the process of CBT, the first session of therapy is a general
analysis of what the client wants to overcome through therapy. Goals for the week are discussed
and from that the therapist will assign homework that is expected to be done for the next session.
Assigned homework may very well include writing a list of goals the client plans to accomplish
for the week or writing down his thoughts in a journal or a piece of paper. This helps with the
control of the behavior and the negative actions that the client does on a daily basis. While CBT
is usually one-on-one, it also works for groups and families having an equal relationship between
client and therapist (Martin, 2007, p.2).
The Therapist’s Job
There are several requirements for a good counselor being personal and business wise. In
order to be a professional, counselors must have the proper education in the practices and therapy
she plans to lead. According to Doherty (2002) there are two types of therapists, a beginner
therapist and an experienced therapist. Although Doherty states his reasoning for couple’s
therapy this also goes for family therapy as well. A beginner therapist, as Doherty (2002)
explains, loses structure and allows him or her to interrupt the other and bash one another while
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
an experienced therapist does not allow the session to get out of hand. Experienced therapists can
reflect openly and deeply on values and broader social forces. This means that an experienced
therapist can see the issues coming from both sides and is able to think more broadly about the
situation. Great advice and support is what the counselor provides in making important
decisions. Guidance in sessions helps the client to make better choices in his behavior towards
others. Helping clients by guiding them in better behavioral ways is to restate to them what was
interpreted by their situation and ask questions to help get a better understanding that what is
being told is the truth.
Looking at how cognitive-behavioral therapy aims to help with depression, anxiety,
PTSD, and marital distress it shows a gist of how it all works in the long run. Those diagnosed
with behavioral problems are eligible for therapy because not only does it affect relationships but
also everyday life. Depression, according to Leahy (2011), is labeled as a simple problem
because this disorder affects productivity and the desire to work. He argued that “depression is
the leading cause of medical disability for people aged 14 to 44 (as cited in Stewart, Ricci, Chee,
Hahn, & Morganstein, 2003). This means that depression is a large enough problem that therapy
should be taken in order to treat it. This is shown in those such as graduate students who are a
part of a counseling program and experience depression from the program related
responsibilities.
Graduate students face stressors in college from finances, research, teaching,
employment, and publishing. Prosek, Holm, & Daly (2013) explain that graduate students have
shown signs of depression attributed from their counseling program and seek counseling as well.
A study was conducted with all students enrolled at a master’s degree level in a counseling
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
program at a Southern state university. The students went through counseling services that is
required by the counseling program curriculum to measure if their mental health problems
decreased after counseling (Prosek, Holm, & Daly, 2013). The participants completed a pre and
post ASR (Adult-Self Report) that analyzed the total problems that being moody, tired,
overwhelmed, or exhausted. The researchers found that students enrolled in a counseling
program are not affected by the mental health distress of the general student population but did
show a decrease of depression symptoms and problems (Prosek, Holm, & Daly, 2013). This
research clearly shows that mental health distress in graduate students is not caused by the
student body but mostly from the program that they are in.
In order to successfully help a client find ways to better their behavioral issues or help
find ways to cope with his or her life problems, a therapist must be well experienced. In other
words therapist’s becomes the best at her job through experience, education and learning.
Education is a really huge part in being a counselor because without the knowledge then there is
no way that she can help someone with their problems if she isn’t educated in that area. It is
required to have at least a master’s degree in order to be a professional counselor and get a
license. Some continue their education to the doctoral level this is only preferred by the therapist
and not licensure required. To be a therapist she must contain her focus at a master’s or doctoral
level in family therapy. Research shows that a therapist doesn’t get the necessary depth of
training that is needed. Woody (1969) states “opportunities for training in behavioral counseling
are limited and training programs seldom provide a thorough grounding of behavioral sciences”.
This means that therapists are basically left to do the necessary training on their own through
jobs and learning ways to go about CBT. Training must go beyond academic knowledge and
practicum experience (Woody, 1969, p. 87).
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
Looking at the expectations of a therapist during CBT and what is learned through
academics and personal experiences it’s concluded that one must have certain skills. These skills
include communication, patience, organizational skills, maturity of the self, and prone to growth.
Having good communication skills mean that she will listen and understand the client without
judging in full. In this way she analyzes the person and gets to know him or her just by their
verbal and non-verbal communication. Although this is not judging the person this allows the
counselor to figure out how to come up with ways to help. Some clients will give the counselor
the run around about how they feel because they may not trust the counselor right away to help
them. In this case the counselor may read body language to understand that the person may be
hiding something that he doesn’t want to disclose right away. It is then the counselor job to
positively stop them and keep the conversation on track as to getting to the source of the
problem. Counselors also must consider a client’s family structure and background while doing
therapy because they may handle situations differently or respectively doesn’t disclose very
personal information. A counselor also must importantly have the patience in certain situations
because families are unpredictable and the session could potentially get out of hand. It is the
therapist’s job to calm the situation and not only make them feel comfortable but for the client as
well. Another good quality to have is being organized. Being organized means that the therapist
has taken well written and lengthy notes about all client situations which help the therapist be
able to refresh the mind of the previous meeting. This ensures that the therapist is conducting
business professionally. Consequences can come of this if it isn’t done right. The records of a
patient are important and complaints will be made if issues with confidentiality, for instance,
come into play. Other requirements include a personal basis and that is to be mature and willing
to be able to grow and expand their knowledge even as a therapist. It is the counselor job to come
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
up with many techniques and ways to apply them with their client because each person is
different. One technique may not work for the client so it is the duty of the counselor to quickly
think of other ways to solve the problem. These techniques in CBT can be improvements or
changes in learned coping skills, goals in behavior, or learned ways of dealing with life
problems.
Do Therapists Think CBT is not Effective?
Indeed, some therapists say that therapy only focuses on small problems. Some therapists, like
Dr. David M. Allen, a psychoanalytic psychiatrist, believes that cognitive behavioral therapy is
not effective and doesn’t really focus on the big problem it only solves simple problems (as cited
in Leahy, 2011, p.1). Surely some people have bigger issues than others and the issue can be so
broad that there will be complications in trying to figure out where to start. This refers to
Doherty and how he explains an experienced therapist (2002). Experienced therapists don’t need
a guide for a starting point she is just able to apply the required structure of CBT and go from
there. In a study conducted by Hahlweg & Klann (1997), was done to evaluate the effectiveness
of marital therapy in Germany. Hahlweg & Klann (1997) concluded the following:
One way to improve the
service is to ensure that future marital therapists
are trained in marital therapy approaches with
established effectiveness that specifically take
the rather short-term nature of counseling into
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consideration. Furthermore, the theoretical models should be based on the marital system and not
on the individual, and these models should have at least some empirical support. (p. 420).
With the idea of empirical support needed for counseling, Leahy (2011), agrees and says that
CBT is empirically based. He argues this by saying “we cannot simply use anecdotes,
testimonials, narratives, or tirades to guide our choice of treatments” and that therapy should rely
on empirical research (Leahy, 2011, p. 1). By imposing empirical support it gives CBT its
credibility with proven facts and data.
How does Couple Therapy Play a Role?
Therapy for marital couples can go either way, although it can be the same for families,
couples are different because therapy then relies as a dyadic session. When couples experience
distress in the relationship, it takes a toll not only on them but for the kids as well. Studies have
shown that people need to have a social connection within their occupation that helps them to see
things from a different perspective.
Additionally, CBT helps with post war veterans diagnosed with PTSD whom carry their
distress in their marriage. Ahmady et al., (2009) say that 9% to 24% of war veterans are
diagnosed with PTSD. Veterans with PTSD tend to express or show their distress by acting out
violently. In a study of 100 veterans diagnosed with PTSD. Post war veterans who were
diagnosed with PTSD tend to carry the distress back home to their significant other. This affects
the couple because those with PTSD often act out their anger violently not because of their wife,
but because of the trauma experienced from war. Shellenbarger (2008) says, “counseling
techniques for post-traumatic stress disorder include discussing facts about the trauma, the
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BENEFITS OF COGNITIVE BEHAVIORAL THERAPY
feelings and symptoms it caused and what it means to the victim. This process helps victims
understand how to identify and control the emotional effects of the trauma in their day-to-day
lives and decision-making” (p. 1).
Couple’s therapy can be difficult because professional counselors take courses according
to family therapy and not marital therapy says Doherty (2002). This means it takes a therapist
who is well experienced who indeed makes mistakes in therapy but fixes and learns from them
right away. Because it is not taught on how to deal with couple’s it is the therapist’s duty to
figure out these techniques and goals to set for the couples. The children are affected in marital
distress because kids don’t want to witness their parents have problems, which is one reason why
children have resentment towards their parents now. On the other hand when some married
couples have step children involved, problems occur on some level. Doherty (2002) mentions a
remarried couple and the mother having three children. The husband felt left out because his wife
was giving more attention to her children in which she should. The mother was torn because she
knew that she had to be there for her kids but also couldn’t figure out how to give her love to her
husband as well (Doherty, 2002). When the mother consulted with her therapist she learned how
to deal with this by going through CBT. During therapy the mother’s therapist combined her
clinical skills with her own personal experience and made her aware that she cannot please
everyone (Doherty, 2002). The couple then realized how they should go about their relationship
which is an accomplished goal in CBT, realizing what needs to be done to help solve the
problem.
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Alternative of Face-to Face Counseling
Moreover research has shown that an alternative prediction to in person counseling, or CBT, is
online counseling. Internet counseling has been proven to be more convenient for those who
prefer not to do counseling face-to-face. With the use of emoticons, descriptive words, and
punctuation the therapist can learn what the client is thinking or feeling through nonverbal
communication. In 2002 more than 16 million people internet searched mental health
information (Pollock, 2006). If cyber counseling is true, then this will benefit families and
individuals at their leisure. But, also considering that even though cyber counseling is for
convenience matters, clients who seek help through the internet may have the potential to
exaggerate issues or issues may be too big to handle through cyber counseling and have to result
eventually face-to-face. This is why people should go through CBT and make a one-to-one
connection with the therapist. This connection builds the confidence in the client to be able to
open up and express his personal feelings without being judged (Martin, 2007).
All the while CBT should be experienced first because talking in person with someone
may be more beneficial and comforting than online although videoconferencing is available. The
future of internet counseling is happening now and can’t be stopped. Growth of resources
through the internet is expanding as well as internet communication. Although internet
counseling is cost-effective (Pollock, 2006, p. 66) it increases a sense of privacy and decreasing
concerns with interpersonal skills. Though online counseling may just widely expand and be the
start of a new era, it should be kept in mind that the efficacy of CBT helps in ways of reducing
symptoms of many disorders for those who seek therapy. The learned goals and techniques can
last in the long run just as long as the client continues to apply these learned techniques
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throughout their life. Anyone experiencing any kind of distress should seek counseling,
therapists are always happy to help people change their life. Furthermore, keep in mind to not
ignore symptoms of depression, anxiety or distresses know yourself and be willing to change.
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References
Ahmady, K., Karami, G., Noohi, S., Mokhtari, A., Gholampour, H., & Rahimi, A. (2009). The
Efficacy of Cognitive Behavioral Couple's Therapy (CBCT) on Marital Adjustment of
PTSD-diagnosed combat veterans. Europe's Journal Of Psychology, 5 (2), 31-40.
Doherty, W. J. (2002, December). Bad couples therapy: how to avoid it. Retrieved on February
6, 2014, from http://www.smartmarriages.com/badcouples.doherty.html
Gaspard, T. (2014, January 24). Marriage Counseling: Does It Help Or Not?. Huffington Post.
Retrieved from, http://www.huffingtonpost.com/terry-gaspard-msw-licsw/marriagecounseling-does-_b_4655577.html
Grohol, J. (2008). How Effective is Cognitive Behavioral Therapy (CBT) for Anxiety?. Psych
Central. Retrieved on February 6, 2014, from
http://psychcentral.com/blog/archives/2008/06/28/how-effective-is-cognitive-behavioraltherapy-cbt-for-anxiety/nseling-does-_b_4655577.html
Hahlweg, K., Klann, N. (1997). The effectiveness of marital counseling in germany: a
contribution to health services research. Journal of Family Psychology, 11 (4), 410-421.
DOI: 10.1037/0893-3200.11.4.410-421
Leahy, R. L. (2011, November). Cognitive-Behavioral Therapy: Proven Effectiveness. Retrieved
on February 6, 2014, from http://www.psychologytoday.com/blog/anxietyfiles/201111/cognitive-behavioral-therapy-prov
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Martin, B. (2007). In-Depth: Cognitive Behavioral Therapy. Psych Central. Retrieved on
February 25, 2014, from http://psychcentral.com/lib/in-depth-cognitive-behavioraltherapy/000907
Pollock, S.L. (2006). Internet counseling and its feasibility for marriage and family counseling.
The Family Journal, 14 (1), 65-70. DOI: 10.1177/1066480705282057
Prosek, E. A., Holm, J. M., & Daly, C. M. (2013). Benefits of required counseling for counseling
students. Counselor Education & Supervision, 52(4), 242-254. DOI:10.1002/j.15566978.2013.00040.x
Shellenbarger, S. (2008, November 12). Advances in couples therapy tackle trauma of infidelity.
Wall Street Journal - Eastern Edition. p. D1.en-effectiveness
Woody, R. (1969). Behavioral counseling: role definition and professional training. The
Counseling Psychologist, 1 (84), 84-88. DOI: 10.1177/001100006900100414
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